COVID-19 is a new severe acute respiratory infection that arises from coronavirus SARS-CoV-2, that has spread around the world, including Kazakhstan. Here, a fatal clinical case with COVID-19 in East Kazakhstan was presented. Case Report: A 40-year woman complained of severe weakness, fever (39,0 o C), body aches, headache, malaise, dry cough, chest pain, shortness of breath, feeling of lack of air for four days. The condition was severe due to acute respiratory and acute cardiovascular

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... She was inhibited; her skin was cyanotic, cold. Her temperature -35 o C, cachexia, breath rate -39/min, blood pressure -50\30 mmHg., pulse rate -122/min, SO 2 -52, weak breathing in auscultation of lungs, moist rales and hepatomegalia. She did not travel outside the city, the history of alcohol abuse. Laboratory examination revealed leukopenia, thrombocytopenia, ESR acceleration, CRP increase, and positive PCR of nasopharyngeal smear on COVID-19. Chest Х-ray showed bilateral focal pneumonia. Acute onset, toxemia, pneumonia, severe course complicated with acute respiratory and acute cardiovascular failure, positive PCR on COVID-19 were supported by a clinical diagnosis of COVID-19, pneumonia, severe course. Complications includedacute respiratory failure II-III, acute respiratory distress syndrome, accompanying disease -alcohol intoxication. Antibiotic therapy with Clavam 1200 mg x 1 time intravenous N1 were started together with intravenous fluid infusions. Tracheal intubation was performed. Although mechanical ventilation and ongoing resuscitation saturation did not rise, cardiac arrest developed and resulted in death. Conclusion: The physicians should be aware of the clinical presentations of the severe pneumonia as local cases of the COVID-19.